At each new pregnancy consultation, I ask my patient if they have any ideas about the way they would like to birth their baby. Most new mothers indicate a preference for a vaginal delivery and a labor process that is as natural as possible, though most are not willing to take an epidural off the table. I always counsel my patient that they certainly are capable of having an unmedicated delivery. If this were not the case, we would not all be sitting here today. Women have been delivering their babies without pain relief for all of time. However, I also counsel my patients that without proper physical and mental conditioning, ultimately they are unlikely to choose to have an unmedicated delivery because labor is very hard work and if they are unprepared for it, they will most likely want an epidural. But beyond the consideration of an epidural, taking good care of their bodies with proper diet and exercise helps reduce their need for all medical interventions and makes a vaginal delivery more likely. There is nothing I can do as a physician to help a woman have a natural birth which is more important than her taking good care of herself throughout the pregnancy and preparing well for working through an unmedicated delivery. When it comes to natural birth, a woman cannot just try, she must do.
Proper self-care in pregnancy forms the foundation of a natural birth. Unfortunately, in modern time-starved obstetrics practices, few women receive counseling about the importance of proper diet and exercise unless a problem, such as gestational diabetes or excessive weight gain, has already developed. Few women are encouraged to attend childbirth preparation and the western medical viewpoint acknowledges the mind–body connections only to a limited extent, so an even smaller number of women receive any instruction in stress-reduction techniques or emotional preparation for either childbirth or parenthood. There are three hurdles to overcome in order for women to begin receiving this type of counseling in pregnancy and apply it to their pregnancy. First, as with all lifestyle modification initiatives, health care providers must begin to appreciate its value and believe it is something they can influence. Second, outpatient care structures must be modified to accommodate the time required to address these issues. Most physicians and midwives have 15 minutes or less to spend at each antenatal visit. This leaves barely enough time to perform a quick check up and address any immediate questions or concerns. Finally, women themselves must be willing to devote time to both receiving the education and committing themselves to making recommended changes in their own lifestyle. This should be a priority for all women, but for women hoping to have a natural birth, it is an essential part of making their plan a reality.
CRITICAL LIFESTYLE MODIFICATIONS FOR A NATURAL BIRTH